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50 Signs of Mental IllnessA Beautiful MindA Beautiful MindA Bright Red ScreamA Casebook of Ethical Challenges in NeuropsychologyA Corner Of The UniverseA Lethal InheritanceA Mood ApartA Research Agenda for DSM-VA Slant of SunA War of NervesAbnormal Psychology in ContextADD-Friendly Ways to Organize Your LifeAddiction Recovery ToolsAdvance Directives in Mental HealthAggression and Antisocial Behavior in Children and AdolescentsAl-JununAlmost a PsychopathAlterations of ConsciousnessAm I Okay?American ManiaAmerican Psychiatric Publishing Textbook of Neuropsychiatry and Clinical NeurosciencesAn American ObsessionAngelheadAnger, Madness, and the DaimonicAnthology of a Crazy LadyApproaching NeverlandAs Nature Made HimAsylumAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderBeing Mentally Ill: A Sociological Theory Betrayal TraumaBetrayed as BoysBetter Than ProzacBetter Than WellBeyond AppearanceBeyond ReasonBinge No MoreBiological UnhappinessBipolar 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ChildrenEmotions and LifeEmpowering People with Severe Mental IllnessEssential PsychopharmacologyEssentials of Cas AssessmentEssentials of Wais-III AssessmentEthics and Values in PsychotherapyEthics in Mental Health ResearchEthics in Psychiatric ResearchEthics, Culture, and PsychiatryEverything In Its PlaceFamily Experiences With Mental IllnessFatigue as a Window to the BrainFear of IntimacyFinding Iris ChangFinding Meaning in the Experience of DementiaFlorid StatesFolie a DeuxFor the Love of ItForensic Nursing and Multidisciplinary Care of the Mentally Disordered OffenderFountain HouseFrom Madness to Mental HealthFrom Trauma to TransformationGandhi's WayGender and Its Effects on PsychopathologyGender and Mental HealthGenes, Environment, and PsychopathologyGetting Your Life BackGracefully InsaneGrieving Mental IllnessHandbook of AttachmentHandbook of DepressionHandbook of Self and IdentityHealing the SplitHerbs for the MindHidden SelvesHigh RiskHope and DespairHow Clients Make Therapy WorkHow People ChangeHow to Become a SchizophrenicHow We Think About DementiaHughes' Outline of Modern PsychiatryHumanizing MadnessHysterical MenHystoriesI Hate You-Don't Leave MeI Never Promised You a Rose GardenI Thought I Could FlyI'm CrazyImagining RobertImpulse Control DisordersIn Others' EyesIn Two MindsInsanityIntegrated Behavioral Health CareIntegrative MedicineIntegrative Mental Health CareIntuitionJust CheckingKarl JaspersKissing DoorknobsKundalini Yoga Meditation for Complex Psychiatric DisordersLaw and the BrainLaw, Liberty, and PsychiatryLegal and Ethical Aspects of HealthcareLiberatory PsychiatryLife at the BottomLife at the Texas State Lunatic Asylum, 1857-1997Life Is Not a Game of PerfectLithium for MedeaLiving Outside Mental IllnessLiving with AnxietyLiving With SchizophreniaLiving with SchizophreniaLiving Without Depression and Manic DepressionLost in the MirrorLove's ExecutionerLoving Someone With Bipolar DisorderMad in AmericaMad TravelersMad, Bad and 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Dr. Mitchell has written this short book for students who are learning about descriptive psychopathology: medical students, residents in psychiatry, psychology students and post-doctoral fellows, social work and nursing students, and other students whose work intersects with the lives and problems of psychiatric patients. My initial reaction, as I began to read the book, was that the chapters were too short and held too little information for these students. As I read on, I changed my mind completely.
Basically, the format of the book is a tour - though fortunately not a comprehensive tour - of the DSM-IV. Each chapter is devoted to a specific disorder, has a brief introduction, lists the current diagnostic criteria for the disorder, then has one or more "stories", followed by a brief discussion, a few questions for further reflection, and a short list of references.
The introductions are very brief and generally get right to the central issues of the diagnostic category. The criteria are - the criteria. The "stories" then put the category in some perspective. They are told from the point of view of the patient and usually someone else - a friend, a spouse, a professional trying to work with the patient. Although these stories are simulated, one can see readily that most are based in part of true and memorable clinical encounters. Mitchell makes some of these patients come alive in these very brief vignettes, and they beautifully illustrate the way the criteria "look" in life as well as the experience of the disorder for both the patient and for those around her. The discussions are often intriguing and ask important questions that seasoned mental health professionals often have stopped asking - to their patients' detriment. The references are few but outstanding for any student wishing to learn more about the disorders or their effects.
My reaction to this book is extremely positive. Rather than inviting students and trainees to memorize a set of criteria, it implicitly makes the point that it is real people who "meet" these rather arbitrary criteria - a truism, perhaps, but one which is often lost on some trainees. As one who works hard to write case vignettes, I know how difficult it is to do this well: Mitchell succeeds. The "stories" are very brief and are constructed with exquisite care. They are often beautifully written. Some of them are brilliant: those for somatization disorder, bipolar disorder, delirium, bulimia nervosa, anorexia nervosa, antisocial personality disorder and body dysmorphic disorder come to mind immediately. The author occasionally introduces a little self-effacing humor as well, which is most welcome. The questions which are at the end of each chapter lead the reader to think more about the case and her or his personal as well as professional reaction to it.
I have very few negative comments. This is not a text of psychopathology or nosology, and it is not intended to be. People seeking such a text should not buy this book. I thought a few of the "stories" - dissociative identity disorder, schizophrenia, substance dependence, obsessive-compulsive disorder, for example --were not as good as the others. A few of the commentaries are really a little bit too sketchy. And anyone can think of a few favorite references which were left out.
It is a tribute to Dr. Mitchell that he accomplished what he did in 222 pages. This is a wonderful, beautifully written book. He makes his views - implicit throughout the book - explicit at the end: "
I have also attempted to make it abundantly clear that these are not stories about illnesses, but instead stories about people
Are the mentally ill different from us? Not really, if we remember that the woman next door may suffer from depression, that the man behind the counter at the drugstore may have panic attacks, that the son of a friend may suffer from schizophrenia, and that you or I may at some time develop a mental illness. It's not 'them', it's 'us'
It seems paradoxical, that as our knowledge of these conditions and the effectiveness of our treatments increase that the percentage of Americans who have no health insurance or inadequate coverage for mental illnesses continues to grow. What good are treatments if people can't receive them?
I encourage those students of psychopathology who read this work
most importantly, to not forget the humanity of the mentally ill, and to advocate for their acceptance and treatment."
This is a superb book for its designated audience. I think philosophers would enjoy the stories very much. I think that seasoned psychiatrists would enjoy and learn from it.
Lloyd A. Wells is a child and adolescent psychiatrist at the Mayo Clinic in Rochester, Minnesota. He has a particular interest in philosophical issues related to psychiatry and in the logic used in psychiatric discourse.
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